A Reference Guide for Postgraduate Specialty Training in the UK
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A Reference Guide for Postgraduate Specialty Training in the UK A Reference Guide for Postgraduate Specialty Training in the UK Applicable to trainees taking up appointments in specialty training which commence on or after 6 August 2008. Trainees taking up appointments in specialty training between 1 August 2007 and 5 August 2008 are covered by the First Edition of the Guide, issued June 2007 The Gold Guide J U N E 2 0 0 8 Second edition Page 1 of 108 A Reference Guide for Postgraduate Specialty Training in the UK Preface This edition of A Reference Guide for Postgraduate Specialty Training in the UK (the “Gold Guide, 2nd Edition 2008”) sets out the arrangements for specialty training in the UK. A Reference Guide for Postgraduate Specialty Training in the UK (2nd edition, 2008) reflects decisions taken in each country applicable to trainees taking up appointments in specialty training which commence on or after 6 August 2008. Trainees taking up appointments in specialty training between 1 August 2007 and 5 August 2008 are covered by the First Edition of the Guide, issued June 2007. In particular, this edition covers the introduction of core training programmes in specialties that “uncoupled” in England, Northern Ireland and Wales with effect from 6 August 2008 – specific arrangements for which are detailed in a Core Training Supplement to this Guide. Throughout the Guide any reference to specialty training includes general practice. Where arrangements differ between specialty training and general practice these differences are noted. The development of this Guide has been through an iterative process of feedback by stakeholders from the Programme Boards in the four administrations. The contribution of stakeholder colleagues from all four Programme Boards is gratefully acknowledged. The standards and requirements set by the Postgraduate Medical Education and Training Board (PMETB) are extensively quoted to ensure that the Guide is underpinned by them and by the General Medical Council’s (GMC) Good Medical Practice. The Gold Guide (2nd edition) is published in electronic format and will be available on the four UK MMC websites. This will enable up-dating of the Guide to ensure that it reflects developments in postgraduate specialty training. Devolved nation supplements may be issued to clarify recruitment and selection procedures in due course. The protocol for future amendments of the Guide is at Appendix 12. There is also scheduled to be a formal review by August 2010. Page 2 of 108 A Reference Guide for Postgraduate Specialty Training in the UK A Reference Guide for Postgraduate Specialty Training in the UK: “The Gold Guide” Table of Contents Preface Section 1: Introduction and background Section 2: Specialty training: policy and the statutory bodies The Statutory Bodies The General Medical Council (GMC) The Postgraduate Medical Education and Training Board (PMETB) Entry to the Specialist and General Practitioner (GP) Registers The Modernising Medical Careers (MMC) UK Co-ordinating Group Royal Colleges and Faculties Postgraduate Deaneries Section 3: Key characteristics of specialty training Standards Structure Section 4: Setting standards Approval of training programmes: standards of training Quality assurance and management of postgraduate medical education Managing specialty training Managing specialty training programmes Training Programme Directors (TPDs) Educational and clinical supervision Section 5: The structure of training Specialty training Fixed Term Specialty Training Appointments (FTSTAs) Sub-specialty certification during and post award of the CCT Filling gaps in training programmes Page 3 of 108 A Reference Guide for Postgraduate Specialty Training in the UK Locum appointments for training (LAT) Locum appointment for service (LAS) The Specialist and GP Registers Applying for consultant posts Continuing as a Specialist Registrar (SpR) or Trainee (SpT) or General Practice Registrar (GPR) Section 6: Becoming a Specialty Registrar Recruitment into specialty training Offers of employment Training Numbers Entry to run-through training in Scotland Entry to specialty training in England, Wales and Northern Ireland Deferring the start of a specialty training programme Registering with the Postgraduate Dean Doctors in specialty training employed permanently outside the NHS Arrangements for the Defence Medical Services Less than full-time training Academic training, research and higher degrees Taking time out of programme (OOP) Movement between Deaneries (inter-deanery transfers) Section 7: Progressing as a Specialty Registrar Competences, experience and performance Annual Review of Competence Progression (ARCP): appraisal, assessment and annual planning Educational appraisal Workplace based appraisal Assessment and the Annual Review of Competence Progression (ARCP) The Annual Review of Competence Progression Panel (ARCP Panel) Outcomes from the ARCP Additional or remedial training The Annual Review of Competence Progression for trainees undertaking joint clinical and academic training programmes The Annual Review of Competence Progression for trainees undertaking out of programme research (OOPR) Page 4 of 108 A Reference Guide for Postgraduate Specialty Training in the UK The Annual Review of Competence Progression for trainees in less than full-time training Annual planning Appeals of the Annual Review of Competence Progression outcomes Section 8: Being a Specialty Registrar and an Employee Accountability issues for employers, Postgraduate Deans and trainees Roles and responsibilities Transfer of information Managing concerns over performance during training Section 9: Appendices Appendix 1: Registering for Postgraduate Training (Form R) Appendix 2: Conditions of taking up a training post Appendix 3: Out of programme Request and Annual Review Document Appendix 4: Inter-deanery Transfer Document Appendix 5: Example form - Educational Supervisor’s Structured Report Appendix 6: Annual Review of Competence Progression (ARCP) Outcomes Appendix 7: Report on Academic Progress Appendix 8: Glossary Appendix 9: Protocol for making revisions to the Guide Page 5 of 108 A Reference Guide for Postgraduate Specialty Training in the UK Section 1: Introduction and background 1.1 This 2nd edition of the Gold Guide sets out the arrangements agreed by the four UK Health Departments for core and/or specialty training programmes. The Guide was commissioned by the UK Modernising Medical Careers Co- ordinating Group (UK MMC CG). 1.2 In September 2005 The General and Specialist Medical Practice (Medical Education, Training and Qualifications) Order 2003 established the Postgraduate Medical Education and Training Board (PMETB) as the new competent authority for postgraduate medical training in the UK. PMETB sets the standards of training and the end-point to be achieved and demonstrated in order to enter the GMC’s Specialist Register and General Practitioner Register. 1.3 A Reference Guide for Postgraduate Specialty Training in the UK (2nd edition, 2008) is applicable to trainees taking up appointments in core and/or specialty training programmes which commence on or after 6 August 2008. Trainees taking up appointments in specialty training between 1 August 2007 and 5 August 2008 are covered by the First Edition of the Guide, issued June 2007. 1.4 Throughout this document reference to specialty training includes general practice. Where arrangements differ between specialty training and general practice, these differences are noted in the Guide. 1.5 All doctors recruited into PMETB approved core and/or specialty training programmes are known as Specialty Registrars (StRs) in all years of their programme. Specialist Registrars (SpRs) and General Practice Registrars (GPRs) appointed before August 2007 will retain the title of SpR/GPR unless they switch to the new specialty curricula. 1.6 SpRs, GPRs and SpTs who were appointed prior to August 2007 may continue to train using the curriculum to which they were appointed or may choose to switch to the new curriculum (para 5.51) after obtaining advice from the Postgraduate Deanery. The “Orange and Green Books” will continue to be applicable to those who remain on the old curriculum, as will the rules/guidance set out by the Specialist Training Authority (STA) and the Joint Committee for Postgraduate Training in General Practice (JCPTGP) which were responsible for supervising specialist and general practice training respectively prior to September 2005, except where legal requirements prevent this (e.g. requirements for prospective approval of training). In addition, this Guide does not cover arrangements for dental training which are still set out within the Guide to Specialist Training, 1998 (“Orange Book”). Nor does it address issues relating to terms and conditions (e.g. pay, extension of training [the “period of grace”]) of doctors in specialty or general practice training. 1.7 The policy underpinning this Guide is applicable UK wide, but there are some national variations in its implementation. These have been highlighted appropriately. Page 6 of 108 A Reference Guide for Postgraduate Specialty Training in the UK 1.8 Doctors who wish to enter specialty training (whether into core/specialty programmes or FTSTAs) must apply in open competition. Page 7 of 108 A Reference Guide for Postgraduate Specialty Training in the UK Section 2: Specialty training: policy and the statutory bodies The Statutory Bodies 2.1 The statutory authorities are, for undergraduate medical education, the General Medical